Provider Demographics
NPI:1538361415
Name:POWERS, JESSICA FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:FAITH
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NUT TREE RD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-4100
Mailing Address - Country:US
Mailing Address - Phone:707-624-8000
Mailing Address - Fax:
Practice Address - Street 1:1020 NUT TREE RD
Practice Address - Street 2:SUITE 390
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4100
Practice Address - Country:US
Practice Address - Phone:707-624-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA119859207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology